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KMID : 0361120130270020067
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Korean Journal of Transplantation
2013 Volume.27 No. 2 p.67 ~ p.71
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A Brain Tumor from a Posttransplant Lymphoproliferative Disorder in a Kidney Transplant Recipient
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Paek Jin-Hyuk
Kim Yae-Rim
Jang Mi-Hyun
Hwang Eun-Ah
Han Seung-Yeup
Park Sung-Bae
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Abstract
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Posttransplant lymphoproliferative disorder (PTLD) is a life-threatening complication from organ transplantation. PTLD usually manifests as a mass in the lymph node or an extranodal mass in solid organs, such as the liver, transplanted kidney, tonsil, bone marrow, or spleen. PTLD rarely involves the central nervous system (CNS); however, here we report a case of PTLD that manifested as a brain tumor after kidney transplantation. A 52-year-old man who started peritoneal dialysis due to autosomal dominant polycystic kidney disease, underwent kidney transplantation 4 years ago. After kidney transplantation, he took tacrolimus, mycophenolate mofetil, and steroids. He was admitted to our hospital, complaining of a severe headache. Brain magnetic resonance imaging showed a multifocal, irregular, and round enhancing mass in the left basal ganglia. He underwent a needle biopsy for the enhancing mass and the pathological diagnosis was diffuse large B cell lymphoma. After this mass was confirmed as PTLD by histologic diagnosis, the patient had a reduction in his immunosuppression regimen (including a change from tacrolimus to sirolimus) and was treated with chemotherapy for PTLD. After 20 days, the patient expired from sepsis. PTLD involving the CNS is a rare and serious complication associated with solid organ transplantation. PTLD should be included in the differential diagnosis of brain tumors in recipients of solid organ transplants.
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KEYWORD
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Posttransplant lymphoproliferative disorder, Kidney transplantation, Brain neoplasms
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